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Maine rates for HCPCS A4376

Ostomy pouch, drainable, with faceplate attached, rubber, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $42.66 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $47.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $33.88 / $46.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $69.18
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $46.77 / $131.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $25.70 / $25.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $34.67 / $60.26